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健康风险因素对澳大利亚人医疗资源利用、工作相关结局和健康相关生活质量的影响:基于人群的纵向数据分析。

Impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life of Australians: a population-based longitudinal data analysis.

机构信息

Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.

School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.

出版信息

Front Public Health. 2023 Nov 27;11:1077793. doi: 10.3389/fpubh.2023.1077793. eCollection 2023.

Abstract

BACKGROUND

Health risk factors, including smoking, excessive alcohol consumption, overweight, obesity, and insufficient physical activity, are major contributors to many poor health conditions. This study aimed to assess the impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life (HRQoL) in Australia.

METHODS

We used two waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) Survey from 2013 and 2017 for the analysis. Healthcare resource utilization included outpatient visits, hospitalisations, and prescribed medication use. Work-related outcomes were assessed through employment status and sick leave. HRQoL was assessed using the SF-6D scores. Generalized estimating equation (GEE) with logit or log link function and random-effects regression models were used to analyse the longitudinal data on the relationship between health risk factors and the outcomes. The models were adjusted for age, sex, marital status, education background, employment status, equilibrium household income, residential area, country of birth, indigenous status, and socio-economic status.

RESULTS

After adjusting for all other health risk factors covariates, physical inactivity had the greatest impact on healthcare resource utilization, work-related outcomes, and HRQoL. Physical inactivity increased the likelihood of outpatient visits (AOR = 1.60, 95% CI = 1.45, 1.76 < 0.001), hospitalization (AOR = 1.83, 95% CI = 1.66-2.01, < 0.001), and the probability of taking sick leave (AOR = 1.31, 95% CI = 1.21-1.41, < 0.001), and decreased the odds of having an above population median HRQoL (AOR = 0.48, 95% CI = 0.45-0.51, < 0.001) after adjusting for all other health risk factors and covariates. Obesity had the greatest impact on medication use (AOR = 2.02, 95% CI = 1.97-2.29, < 0.001) after adjusting for all other health risk factors and covariates.

CONCLUSION

Our study contributed to the growing body of literature on the relative impact of health risk factors for healthcare resource utilization, work-related outcomes and HRQoL. Our results suggested that public health interventions aim at improving these risk factors, particularly physical inactivity and obesity, can offer substantial benefits, not only for healthcare resource utilization but also for productivity.

摘要

背景

健康风险因素,包括吸烟、过度饮酒、超重、肥胖和缺乏身体活动,是许多不良健康状况的主要原因。本研究旨在评估健康风险因素对澳大利亚医疗保健资源利用、工作相关结果和健康相关生活质量(HRQoL)的影响。

方法

我们使用了 2013 年和 2017 年两次全国代表性的家庭、收入和劳动力动态调查(HILDA)的数据进行分析。医疗保健资源利用包括门诊就诊、住院治疗和处方药物使用。工作相关结果通过就业状况和病假来评估。HRQoL 使用 SF-6D 评分进行评估。使用广义估计方程(GEE),对数或对数链接函数和随机效应回归模型分析健康风险因素与结果之间的纵向数据关系。模型调整了年龄、性别、婚姻状况、教育背景、就业状况、均衡家庭收入、居住区域、出生地、土著身份和社会经济地位。

结果

在调整所有其他健康风险因素协变量后,身体不活动对医疗保健资源利用、工作相关结果和 HRQoL 的影响最大。身体不活动增加了门诊就诊(AOR=1.60,95%CI=1.45,1.76 < 0.001)、住院(AOR=1.83,95%CI=1.66-2.01, < 0.001)和请病假的可能性(AOR=1.31,95%CI=1.21-1.41, < 0.001),并降低了具有高于人口中位数 HRQoL 的可能性(AOR=0.48,95%CI=0.45-0.51, < 0.001),调整所有其他健康风险因素和协变量后。肥胖对药物使用的影响最大(AOR=2.02,95%CI=1.97-2.29, < 0.001),调整所有其他健康风险因素和协变量后。

结论

我们的研究为有关健康风险因素对医疗保健资源利用、工作相关结果和 HRQoL 的相对影响的不断增长的文献做出了贡献。我们的结果表明,旨在改善这些风险因素的公共卫生干预措施,特别是身体不活动和肥胖,可以带来实质性的好处,不仅对医疗保健资源利用,而且对生产力也有好处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4deb/10711273/d3336fde6b90/fpubh-11-1077793-g0001.jpg

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